Helping hands, after hours
Pulse editor
Sunday, October 19, 2008
Nurses don’t check their skills at the door when they leave health care settings. When nurses are off the clock, they often go out into the world to serve where they’re needed most.
Mission trips, community clinics, disaster relief efforts — you’ll find nurses in the thick of things.
Photos by BARRY WILLIAMS/Special
Jo Ann Armstrong, a nurse in the endoscopy unit at St. Joseph’s Health System, removes an IV from Brenda Ingraffia’s arm after a colonoscopy.
Pam Kramer (right), co-founder of the Gwinnett Community Clinic, reviews a patient’s chart with Jeryi Amason, a nurse at the clinic.
Emory Healthcare nurses Wendy Nesheim (left) and Mary B. Bower examine forms used in a vaccine clinical trial.
Here are stories about three metro Atlanta nurses who help people at work — and in their spare time.
JO ANN ARMSTRONG: MISSION POSSIBLE
A staff nurse in the endoscopy unit at St. Joseph’s Health System in Atlanta, Jo Ann Armstrong, RN, BSN, spends part of her vacation time every year doing mission work.
“In 2003, my best friend called from my hometown — Jackson, Miss. — to say that Covenant Presbyterian Church needed a nurse,” she said.
The church, which was taking a group to San Pedro, Honduras, to set up a 10-day dental/medical clinic, didn’t have a nurse for the trip.
“When she called, I realized that God had been preparing me for this for the last six months,” Armstrong said.
“Everywhere I went — from a girl’s get-together to a concert — people had been talking about missions. So I said, ‘Yes, I think I’m supposed to go.’ “
With medication supplied by MAP (Medical Assistance Programs) International, the group set up a clinic in a church in Honduras and treated people who had diabetes, worms, skin infections and other diseases. The church then started a soup kitchen to improve the diet of the population there.
In 2004, Armstrong joined a group from her church, Mount Pisgah Methodist, to participate in Bruce Wilkinson’s The Dream Giver project.
“On that trip we all planted 12-foot-by-12-foot gardens of spinach and cabbage in the villages around Durbin, South Africa, to combat hunger,” she said.
She goes on one or two mission trips a year, most recently to Nicoya, Costa Rica, where she was the sole medical professional running a clinic.
Doctors and nurses at St. Joseph’s support her mission efforts.
“They always ask where I’m going, and [they] donate supplies and money,” she said. “The hospital allows me to shop wholesale in the pharmacy and the pharmacists show me how to get the biggest bang for my buck. I also get drugs from MAP International.
“And before every trip, Sister Sally [White, a pastoral care nun at St. Joseph’s] prays over me. I’m blessed to work here.”
Armstrong says that she’s never felt scared to work in remote areas of the world. Although she doesn’t speak Spanish, Armstrong has learned you don’t need language to communicate love and compassion.
“I’ve been unbelievably blessed with all the opportunities I’ve had in my life,” she said. “This is a way I have of giving back, and I have a passion for it.”
PAM KRAMER: CLINICAL CARE
In the late 1980s, two church friends — Pam Kramer, RN, BSN, and Madeline Estefan — decided to do something about homelessness. They had intended to start a homeless shelter, but discovered that Gwinnett County already had one.
“At a county focus group, we learned that what they really needed was a medical clinic to treat people who were uninsured,” said Kramer, director of physician support services and of the oncology program at Emory Eastside Medical Center in Snellville.
“Dr. Laurence Lesser, a local cardiologist, got behind it and encouraged his colleagues to buy in,” Kramer said. “They asked me to be in charge of the nurses. At the time, I had a 3-year-old child and was working in ER, but my husband said, ‘Go for it.’ “
After months of preparation, the Gwinnett Community Clinic opened on Dec. 14, 1989. Thanks to a $50,000 grant from the Georgia Health Foundation, donated medicines and supplies, and physician and nurse volunteers, the clinic operated three nights a week at the Lawrenceville Health Department. Kramer worked at her hospital job and then every night at the clinic during the first year.
“It was Dr. Lesser convincing so many physicians to participate that kept this from being a band-aid clinic,” she said. “From the beginning, we offered a full course of treatment.”
For $5, patients got a doctor’s visit, diagnostic tests and necessary medications.
“Subspecialists agreed to donate their time and services for clients who needed surgery and more expensive treatment,” she said. “We had a list and rotated our referrals. The hospitals discounted or wrote off their services.
“For patients who were down on their luck and in a bad place, we were there to fill the gap”
Still going strong, the clinic now operates two nights a week at Eastside Emory’s wound care center. The fee is now $10, and there’s a cap on prescription refills. Grants and donations have allowed the clinic to hire a nurse practi-tioner to provide continuity to the volunteer medical staff.
“We’re a 501-c [nonprofit] and have never had government assistance,” Kramer said. “Our budget runs about $120,000 a year, but we deliver millions of dollars worth of care a year.”
Kramer, who is on the clinic’s board, helps facilitate the care of clinic patients at Eastside Emory.
“Our brochure says, ‘Inspired by God, developed by servants and continued by volunteers,’ and that’s true,” she said. “When God calls you to do something, he enables you to do it, and that’s why I believe we’ve been successful.”
WENDY NESHEIM: FLIRTING WITH DISASTERS
A desire to help refugees from war-torn Kosovo caused Wendy Nesheim to join the National Disaster Medical System in 1999.
“Because the paperwork, security clearance and training took so long, I missed that opportunity [to serve in Kosovo],” said Nesheim, RD, M.Ed., a clinical trials nurse researcher with Emory Healthcare. “Instead, my first deployment was to the World Trade Center site in New York after 9/11. We set up MASH-unit tents near Ground Zero, and for two weeks treated the police officers, firemen and construction crews working there.”
Nesheim says it was tough working at the site, but a teddy bear sent by a boy from New Mexico and delivered by the Salvation Army reminded her that the country was behind everyone who worked there.
Nesheim serves with the Georgia-3 Disaster Medical Assistance Team, part of the Federal Response Team Plan for natural and man-made disasters. The team of nurses, doctors, pharmacists and other health care professionals provides care and relief for victims of hurricanes, floods and other disasters.
“We’re trained and equipped to go into austere situations and be self-sustaining,” Nesheim said. “We carry trucks filled with tents, supplies, food, medicines, and can see up to 250 people a day.”
The team helped in New Orleans after Hurricane Katrina three times. Nesheim recently returned from Baton Rouge, La., where the team ran a shelter for high-risk patients during Hurricane Gustav.
Always packed and ready to go on short notice, Nesheim becomes a federal employee when she is deployed. The time she spends training, however, are volunteer hours.
“We meet monthly and train several long weekends a year,” said Nesheim, the team’s deputy commander. “Everyone has to know how to set up the base of operations, and [must] pass competency exams in suturing, intubating, infusing and other medical skills.”
Deployments are mentally and physically exhausting.
“We work 12- to 14-hour days. By about the tenth day of not sleeping well, in dirty clothes and living on MREs [Meals Ready to Eat], you ask yourself, ‘Why am I doing this again?’ ” she said. “Then we shore each other up and go on. Working in disasters teaches you flexibility and patience.”
Every disaster is different and challenging, but the work is gratifying.
“We just want to help others. Treating 35 to 45 people a day may not make a big difference in the world, but it does to those individual lives, and that’s very rewarding,” she said.
